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General NPI Number Information
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NPI Number | 1265746317
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Entity Type | Individual
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Provider Name | NORMAN MICHAEL JACOBOWITZ MSN, RN-BC, NP-C
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Gender | Male
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Dates
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Enumeration Date | 07/31/2010
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Last Update Date | 07/31/2010
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Provider Practice Location Address
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Address Line | 8575 SUDLEY RD STE B
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City | MANASSAS
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State | VA
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Zip | 20110-3861
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Country | US
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Telephone | 703-361-3161
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 NICHOLAS CT
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City | FAIRFAX
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State | VA
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Zip | 22033-2813
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024168912
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License Number State | VA
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